185486 05/12/2010 CITY OF CARMEL, INDIANA VENDOR: 204038 Page I of 1
f ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $110,00
'y INDIANAPOLIS IN 46204
«o, CHECK NUMBER: 185486
CHECK DATE: 5112/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4358800 19348 203985 55.00 TESTING FEES
1201 R4358800 19348 204155 55.00 TESTING FEES
)93q�
Widwest 7o.Xicoeogy Invo
@4� Inc.
DATE INVOICE
603 East Washington Street, Suite 200, Indianapolis, IN 46204 4/28/2010 204155
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss #II
1 Civic Square Email results to Barb Lamb cc Jim
Carmel, IN 46032 Still Mail results to Jim
AA
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 1 Non -DOT Drug Test 55.00 55.00
Collected at Community Occ. Health Center Carmel
4123!10
Sara McMullen
MAY 10 2010
By
A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business.
Thank you for your business! Total $55.00
Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC.
For questions regarding this invoice, contact us at 317 262 -2200 or fax us at 317 262 -2222.
Be sure to visit our website at wwmnoidwesttoaicology.coin.
Widwest Toxicology Invoice
DATE INVOICE
0 4 wi i i v 4/27/2010 203986
603 East Washington Street, Suite 200, Indianapolis, IN 46204
BILL TO: SHIP TO: I
Cit of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss #II
1 Civic Square Email results to Barb Lamb cc Jim
Still Mail results to Jim
Carmel, IN 46032
NM
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH AMOUNT
ND Drug Test CS 2 Non -DOT Drug Test 55.00 110.00
Collected at Community Occ. Health Center Carmel
4/21/10
Jeremy Mainers
4123/10
Jimmie Kitterman
U MAY 10 2010 I
By
A finance charge will be assessed on all invoices not paid in 30 days. Thank you for your business.
We appreciate your business and thank you for your prompt payment. Total $11 0.00
Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC.
For questions regarding this invoice, contact its at 317- 262 -2200 or fax us at 317- 262 -2222.
Be sure to visit our website at rvww.midwesitoxicology.com.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$2,780.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
19348 203534 43- 588.00 $1,183.00 1 hereby certify that the attached invoice(s), or
203685 43- 588.00 $660.00 bill(s) is (are) true and correct and that the
203748 43- 588.00 $717.00
materials or services itemized thereon for
19 S' s 20398 43- 588.00 $110.00
which charge is made were ordered and
1°t3i)g 204156 43- 588.00 $55.00`
t t3� 204348 43 =58"0 $55.00 J received except
Monday, May 10, 2010
Director, HR
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
04/20/10 203534 $1,183.00
04/22/10 203685 $660.00
04/26/10 203748 $717.00
04/27110 203985 $110.00
04/28/10 204155 $55.00
04/30/10 204348 $55.00
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
1 20
Clerk- Treasurer